E-cigs contain nicotine, an addictive drug that in kids and teens appears to blunt emotional control as well as decision-making and impulse-regulation skills.

A single Juul “pod” delivers about the same amount of nicotine as a pack of regular cigarettes. And Juul Labs has faced scrutiny over claims that it aggressively marketed its sweet-flavored e-cigs to teens.

Smoking kills. No other habit has been so strongly tied to death.

Not surprisingly, vaping, or using e-cigarettes like the Juul, appears to be better for you than inhaling a toxic mix of burned tobacco, tar, and metals. That may be promising news for adult smokers who are struggling to quit with tools like nicotine gums, but experts say further research is needed before they can recommend e-cigs.

Altria, the tobacco company behind Marlboro cigarettes, is a big investor in Juul, paying $12.8 billion for a 35% stake. It’s betting that adults who smoke cigarettes will increasingly decide to vape instead, reducing the damage they’re doing to their bodies.

But e-cigarettes like the Juul are not without health risks.

Because they contain nicotine, e-cigarettes are especially dangerous for kids and teens whose brains are still developing, experts say. In young people, nicotine appears to blunt emotional control as well as decision-making and impulse-regulation skills. That most likely helped prompt a warning about e-cigs from the US surgeon general in December.

And given that it’s still early days for vaping, researchers say there’s a lot we still don’t know about the practice and how it could affect the body.

There’s also worry about how the wider landscape of e-cig devices may affect people’s overall health. Besides all-in-one-style e-cigarettes like the Juul, other “tank-style” devices allow users to tweak everything from the temperature of the device to the amount of nicotine they’re inhaling. Some e-cigs like these appear to contain toxic metals, and using them has been tied to an increased risk of a heart attack.

Here’s what you should know about the health risks of vaping, for both young people and adults.

Juul, nicotine, and teens

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Sarah Johnson/Flickr

Among available e-cigarettes, Juul’s devices, which have been on the market since 2015, offer a uniquely high dose of nicotine: one Juul “pod” delivers roughly the same nicotine content as a pack of regular cigarettes. While Juul maintains that the high nicotine content is key to its success among adult smokers who want to switch, public health experts have said it poses a danger to teens.

Juul maintains that its products are intended only for adult smokers who are looking to quit.

In response to a growing backlash from public health researchers and federal regulators, the company has recently made several moves that it says are intended to keep its products out of young people’s hands. For example, Juul removed the word “cool” from its cucumber flavor, nixed the creme brulee flavor, pulled mango and other fruit options from retail stores, and scrubbed much of its social-media presence.

Juul Labs – which spun off from its parent company, Pax, in 2017 – has also begun to research its devices. On Monday, it published a study reviewed by outside experts. Though that research has important caveats, it’s an early look into the potential for the devices to help adult smokers quit.

Juul has other research in the works. According to ClinicalTrials.gov, the government’s database for clinical studies, Juul recently completed at least five other clinical trials and is conducting at least three more.

Other e-cigs, toxic metals, and heart-attack risk

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People use electronic vaporizers with cannabidiol-rich hemp oil at the International Cannabis Association Convention in New York in 2014.

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Eduardo Munoz/Reuters

Besides the Juul, dozens of other e-cigarette options are available in stores. These devices may pose health risks that range from a heightened exposure to toxic metals to even an increased risk of a heart attack.

Last spring, researchers looked at the vapors that users inhale from several popular non-Juul e-cigarette brands and came away with some potentially troubling results.

In another study published last summer, scientists found evidence tying daily e-cigarette use to an increased risk of a heart attack and suggested that people who vape every day could face twice the risk of a heart attack compared with people who neither vape nor smoke at all.

The most troubling risk was around people who both vape and smoke (so-called “dual users”), a group that researchers determined could face nearly five times the risk. Still, the study has a number of limitations. Most notably, it could not conclude that vaping (or even smoking, for that matter) caused heart attacks – only that the two were linked.

Then in December, US Surgeon General Jerome Adams released a unique warning about e-cigarettes.